You have accessJournal of UrologyProstate Cancer: Localized I1 Apr 2012378 IMPACT OF MARITAL STATUS ON PROSTATE CANCER SPECIFIC MORTALITY AND OVERALL MORTALITY AFTER RADICAL PROSTATECTOMY Kenneth Nepple, Adam Kibel, Gundarshan Sandhu, Dorina Kallogjeri, Seth Strope, Robert Grubb, Kathleen Wolin, and Siobhan Sutcliffe Kenneth NeppleKenneth Nepple St. Louis, MO More articles by this author , Adam KibelAdam Kibel Boston, MA More articles by this author , Gundarshan SandhuGundarshan Sandhu St. Louis, MO More articles by this author , Dorina KallogjeriDorina Kallogjeri St. Louis, MO More articles by this author , Seth StropeSeth Strope St. Louis, MO More articles by this author , Robert GrubbRobert Grubb St. Louis, MO More articles by this author , Kathleen WolinKathleen Wolin St. Louis, MO More articles by this author , and Siobhan SutcliffeSiobhan Sutcliffe St. Louis, MO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.441AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Analysis from population-based cancer registry data has suggested that being married is associated with improved survival in men with prostate cancer. However, a limitation of such analysis is the inability to control for PSA or medical comorbidity which may differ by marital status. We investigated the association between marital status and both prostate cancer specific mortality (PCSM) and overall mortality (OM) in men treated with radical prostatectomy. METHODS The study population included 3596 men treated by radical prostatectomy at a single institution between 1994 and 2004 and followed for a median of 10.2 years. Disease specific factors (PSA, clinical stage, and biopsy Gleason grade), comorbidity (validated ACE-27 comorbidity index), ethnicity, age, and marital status at time of treatment were retrieved from an institutional cancer registry. Differences between marital status groups were evaluated by Chi square or ANOVA. Multivariable Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of PCSM and overall mortality OM by marital status. RESULTS At the time of diagnosis, 86.9% of men were married, 5.3% divorced, 2.4% widowed, and 5.5% never married. Marital status was associated with differences in PSA (p<0.01), comorbidity (p=0.04), and age (p<0.01). Married men had the lowest mean PSA at diagnosis and never married men were younger and the most likely to have no known medical comorbidity. 441 men (12.2%) were dead at the end of follow up, but only 65 from prostate cancer. On multivariable analyses (Table), never married men had a significantly increased risk of PCSM (Figure) and OM compared to married men, whereas no additional risk was observed for divorced or widowed men. Association of marital status with mortality after radical prostatectomy Marital status Prostate Cancer Mortality HR (95% CI) Overall Mortality HR (95%CI) Married 1.00(reference) 1.00(reference) Divorced 1.59(0.58-4.42) 1.16(0.76-1.76) Widowed 1.01(0.14-7.36) 1.46(0.90-2.35) Never married 2.63(1.02-6.16) 1.79(1.21-2.66) CONCLUSIONS Never married men had an increased risk of PCSM and OM. Factors associated with social isolation or unhealthy behaviors may have a detrimental effect on survival after prostatectomy. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e154-e155 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kenneth Nepple St. Louis, MO More articles by this author Adam Kibel Boston, MA More articles by this author Gundarshan Sandhu St. Louis, MO More articles by this author Dorina Kallogjeri St. Louis, MO More articles by this author Seth Strope St. Louis, MO More articles by this author Robert Grubb St. Louis, MO More articles by this author Kathleen Wolin St. Louis, MO More articles by this author Siobhan Sutcliffe St. Louis, MO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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